MONOARTHRITIS OF THE ELBOW REVEALING AN INTRAARTICULAR OSTEOID OSTEOMA

##plugins.themes.academic_pro.article.sidebar##

Download
pdf
Vol. 87 No. 3 (2009): Issue Mar 2009

##plugins.themes.academic_pro.article.main##

Leila Cheikhrouhou Abdelmoula
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie
Khadija El Manaa
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie
Chiraz Ben Hadj Yahia
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie
Houda Ajlani
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie
Hammadi Lebib
Service d'orthopédie Hôpital Charles Nicolle Tunis à Tunisie
Lilia Chaabouni
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie
Rafik Zouari
Service de rhumatologie Hôpital Charles Nicolle Tunis à Tunisie

Abstract

Background : Osteoid osteoma is one of the unusual causes of musculoskeletal pain. Its diagnosis is usually not difficult in classic diaphyseal localization. However, the diagnosis of juxta or intraarticular osteoid osteoma is challenging because of atypical clinical presentation responsible for long diagnosis delay.
Aim : Report a new case.
Case report: We report herein the case of a 22-year-old woman presenting an intraarticular osteoid osteoma of the elbow. Diagnosis has been established on imaging findings (MRI and CT-scan) after 10 months because of atypical clinical presentation as a chronic monoarthritis of the elbow. The picture of an osteoid osteoma of the lower extremity of the humerus associated to a synovitis and a joint effusion was suspected on MRI. It had been confirmed on CT-scan wich showed the nidus. Surgical removal of the tumor allowed pain relief and functional restoration in postoperatively.
Conclusion: Regarding an unexplained chronic monoarthritis, the diagnosis of intraarticular osteoid osteoma should be evoked. CTscan remains the investigation of choice for identifying the nidus. Surgical exicision permits the relief of symptoms.

Keywords:

osteoid osteoma, elbow, arthritis, imaging

##plugins.themes.academic_pro.article.details##

References

  1. Bannevialle P, Railhac JJ. Ostéome ostéoïde, ostéoblastome. Encycl Méd Chir (editions scientifiques et médicales Elsevier SAS, Paris), Appareil locomoteur, 14-712, 2001,7p.
  2. Chagnon S, Lardé D, Bruckert F, Vallée C. Tumeurs primitives bénignes des os. In: Laredo JD, Morvan G, Wybier M, Eds., Imagerie ostéoarticulaire, Edition Flammarion/ Médecine-Sciences, 2002. p151.
  3. Sendroi M, Kollo K, Antal I, Lakatos J, Szoke G. Intraarticular osteoid osteoma. Clinical features, imaging results, and comparison with extraarticular localization. J Rheumatol 2004 ; 31 : 957-64.
  4. Degreef I, Verduyckt J, Debeer P, De Smet L. An unsual cause of shoulder pain: osteoid osteoma of the acromion - a case report. Shoulder Elbow Surg 2005; 14: 643-4.
  5. Christodoulou A, Ploumis A, Karkavelas G, Terzidis I, Tsagias I. A rare case of juxtaarticular osteoid osteoma of the calcaneus initially misdiagnosed as juvenile chronic arthritis. Arthritis Rheum 2003 ; 48 :776-9.
  6. Francesco B, Andra LA, Vincenzo S. Intrarticular osteoid osteoma of the lower extremity : diagnostic problems. Foot Ankle Int 2002 ; 23 :264-7.
  7. Geargoulis AD, Papageargiou CD, Moebius UG, Rossis J, Papadonikolakis A, Soucacos PN. The diagnostic dilemma created by osteoid osteoma that presents as knee pain. Arthroscopy 2002 ; 18 : 32-7.
  8. Dzupa V, Bartonicek J, Spindrich J, Neuwirth J, Svec A. Osteoid osteoma of olecranon process of ulna in subchondral location. Arch Orthop Traum Surg 2001 ; 121: 117-8.
  9. Yoshido T, Gotoh M, Hirai Y, Shinozaki T, Higuchi F. Monoarthritis of the elbow caused by intraarticular osteoid osteoma. J Rheumatol 2006; 33: 196-7.
  10. Duman I, Aydemir K, Tan AK, Dincer K, Kalyon TA. An unusual case of osteoid osteoma clinically mimicking sacroiliitis. Clin Rheumatol 2006; 14: sous presse.
  11. Kchir MM, Kallel MH, Chaabane M et al. Ostéome ostéoïde de l'olécrâne. Rev Rhum Mal Osteoartic1992;59:357-8.
  12. Franceschi F, Marinozzi A, Papalia R, Longo UG, Gualdi G, Denaro E. Intra- and juxta-articular osteoid osteoma: a diagnostic challenge: misdiagnosis and successful treatment: a report of four cases. Arch Orthop Trauma Surg 2006; 126: 660-7.
  13. Tounsi N, Trigui M, Ayadi K, Kallel S, Boudaouara Sallemi T, Keskes H. Ostéome ostéoïde de l'olécrâne. Rev Chir Orthop Réparatrice Appar Mot 2006; 92: 495-8.
  14. Kawaguchi Y, Soto C, Hasegawa T, Oka S, Kuwahara H, Norimatsu H. Intraarticular osteoid osteoma associated with synovitis: a possible role of cyclooxygenase 2 expression by osteoblasts in the nidus. Mod Pathol 2000; 13: 1086-91.
  15. Gaeta M, Minutoli F, Pandolfo I, Vinci S, D'Andrea L, Blandino A. Magnetic resonance imaging findings of osteoid osteoma of proximal femur. Eur Radiol 2004 ; 14 : 1582-9.
  16. Foeldvari I, Schmidt MC. Rapid development of severe osteoarthritis associated with osteoid osteoma in a young girl. Clin Rheumatol 1998; 17: 534-7.